by adgrooms on October 16, 2019

Data blocking, also known as data siloing, has been a practice across industries that deal with large amounts of data. Information that is related and should be shared between different organizational teams are instead held in a "silo", limiting access and discouraging collaboration. Allowing the free flow of data throughout an organization, on the other hand, can improve the accuracy of the data and eliminate redundancies in the data that contribute to wasted effort. While siloing can happen within an organization, Healthcare organizations and EHR companies have made a practice of data blocking by making the sharing of patient data difficult across organizations. Patients may have information in several places between their primary care provider, specialists, and labs that could exist in separate networks. Connecting all of this information has always been difficult, but EHRs were implemented to enhance data sharing which is counter to blocking practices. So why does data blocking still exist and what are we doing about it?

EHR companies could have built their systems with tools that enable data sharing, but they chose not to, possibly because of the substantial financial and time investment required. This choice had a perceived benefit of severely limiting the ability to share information with competing systems. It also allowed the EHR companies to demand high fees to extract data from their systems further discouraging healthcare organizations from switching to a competing vendor. With tens of billions of dollars to be made in the EHR market, and no regulation against it, data blocking was used to establish dominance in the market by a few companies.

Some healthcare organizations also took part to preserve their market share by making it hard for patients to take their records and their business elsewhere. The problem with this thinking is they are also preventing patients from coming into their organization from competitors. Is the practice of making it difficult for patients to move between networks actually damaging to business? More importantly, for patients, it is preventing them from seeking care that fully serves their needs when it exists at separate institutions. If an institution provides superior care, it could be rewarded with increased demand if the information were easily exchanged. The competitors would have more incentive to improve care to keep a patient with easier mobility and choice of institution.

Blocking of information also creates more waste by requiring redundancies in care when a patient requires multiple providers. When information is blocked, a new provider must make a choice between waiting on information transfer or starting from scratch to get all of the information they need for treatment, a preventable waste of time and resources. Missing information could also be an issue when providers choose not to wait for the information transfer. Relying on a patient's memory to fill in the blanks may or may not be reliable. The inability to attain the full picture of a patient’s history could negatively affect the quality of care. Again, a preventable waste of time and a risk to the patient.

The EHR vendors and healthcare institutions have benefitted from data blocking for years to the detriment of the patient. New rules from the Office of the National Coordinator for Health Information Technology (ONC) are aiming to end data blocking in healthcare for good. The ONC has proposed steep penalties of up to 1 million dollars for health IT developers and health information exchanges that continue the practice. This is a positive step to taking down the silos and working towards interoperability. Patients will have access to their health information and be able to take more control of their health with the right to choose more freely where they seek treatment. New competition and innovation could emerge in the EHR market giving providers a better platform to work with patient data and reducing administrative burden.

Are we witnessing the end of data blocking? How can information sharing be further incentivized for providers and vendors?